DOROTHY L BLACKMUN
Physician/surgeon


Address: 111 West 117th St., New York, NY 10026

DOROTHY L BLACKMUN (Credential# 562476) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.

Business Overview

DOROTHY L BLACKMUN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044894. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 111 West 117th St., New York, NY 10026. The current status is active.

Basic Information

Licensee Name DOROTHY L BLACKMUN
Credential ID 562476
Credential Number 1.044894
Credential Type Physician/Surgeon
Business Address 111 West 117th St.
New York
NY 10026
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2006-11-03
Effective Date 2020-06-01
Expiration Date 2021-05-31
Refresh Date 2020-04-22

Office Location

Street Address 111 West 117th St.
City New York
State NY
Zip Code 10026

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Adewale O Olayode 304 West 117th Street, New York, NY 10026 Physician/surgeon 2020-05-01 ~ 2021-04-30
Yasmin Dhar 23 West 116th Street, New York, NY 10026 Physician/surgeon ~
Bradley E Martin 444 Manhattan Ave, New York, NY 10026 Registered Nurse 2020-03-01 ~ 2021-02-28
Marjorie A Beutel 329 West 112th Street, New York, NY 10026 Tax Preparer/facilitator Permit 2020-02-11 ~ 2022-02-28
Maria Losyeva 136 West 111th Street Apt 3fe, New York, NY 10026 Professional Engineer 2020-02-01 ~ 2021-01-31
Denisha Johnson 283 West 118 Street Apt 3b, New York, NY 10026 Master's Level Social Worker 2018-05-01 ~ 2019-04-30
Derek D Pozzessere 225 Central Park North, New York City, NY 10026 Registered Nurse 2019-08-01 ~ 2020-07-31
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Competitor

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City New York
Zip Code 10026
License Type Physician/Surgeon
License Type + County Physician/Surgeon + New York

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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